What should I and my partner think about before we start trying?

Before you take the plunge, you and your partner may find it helpful to ask yourselves these questions:

Are you both equally committed to becoming parents?

Have you thought through how you’ll handle childcare responsibilities and balancing work and family?

Are you ready to give up spontaneous nights out and sleeping in on Sundays?

Have you thought about how becoming parents may change you, and your relationships with those closest to you?

Are you prepared for the possibility that your child may have special needs?

If you have religious differences, have you discussed how they will affect your child?

Having a baby won’t just have a small impact on your life, it’s going to shift the centre of your universe. Some new parents find this a shock. Think about how you’ll feel, how you usually cope with change, and how you can prepare yourself for the highs (and lows) of parenthood.

Can we afford to have a baby?

You may feel that you’ll never have enough money to bring up children! It’s more important, though, that your baby receives love and attention rather than material goods.

That doesn’t mean it isn’t wise to save a little before you get pregnant. You’ll be financially responsible for your child for at least 18 years, so try to put something aside.

When should we stop using contraception?

For some people, stopping contraception is as easy as shoving the condoms or diaphragm to the back of a drawer.

If you’re coming off the combined pill (combined oral contraceptive or COC), it’s best to stop taking it when you’ve finished one complete cycle of pills (FPA 2017a).

If you’re on the mini-pill (progestogen-only pill or POP) you can stop taking it at any time.

Your period may return in two to four weeks, but you may find it takes up to three months for your menstrual cycle to get back on track (NHS 2018a). You’ll be fertile again when you ovulate, two weeks before your period starts.

The first period after stopping the pill is called a withdrawal bleed. The next period you have after this withdrawal bleed will be your first natural post-pill period (NHS 2018a).

It’s often recommended that you wait until you have at least one normal period before you start trying for a baby (NHS 2018a). You'll then know where your cycle is for conception planning, and this can help with dating your pregnancy.

If you do get pregnant while you’re still on the pill, stop taking it and see your doctor or book an appointment directly with your midwife. Your GP surgery can put you in touch with your nearest midwifery service.

There’s no evidence of an increased risk of miscarriage or abnormalities for women who conceive while taking the pill (Charlton et al 2016). But you may want to reassure yourself by talking it through with your doctor or midwife.

If you’ve been using the contraceptive injection, it may take up to a year for you to return to your usual fertility (NICE 2005).

If you've been using any other type of long-acting contraception – an intrauterine system (IUS), an intrauterine device (IUD) or a progestogen-only implant – your fertility should return to normal as soon as it's removed (NICE 2005).

Do I need to change what I eat if I’m trying for a baby?

Eating well is a good idea if you’re intent on baby-making. Aim for a balanced diet of three meals a day, including at least five daily portions of fruit and vegetables.

Four of the most important nutrients for a healthy start to pregnancy are:

To ensure you have these important nutrients, include the following in your meals:

dairy produce

fruit and vegetables

wholegrains and cereals

protein in the form of lean meat, fish, eggs, pulses or nuts (NHS 2017b)

You can take multivitamins designed for women who are trying to conceive, or an antenatal supplement. These will contain 400 micrograms (mcg) of folic acid. This is a B vitamin that helps to prevent neural tube defects, such as spina bifida in developing babies (CKS 2017).

Some studies have suggested that having a lot of caffeine may affect your fertility (Anderson et al 2010, NHS 2015, OTIS 2011), but there's no clear evidence of a link. However, if you want to try for a baby you may prefer to keep your caffeine intake below 200mg a day to be on the safe side (NHS 2017c). Caffeine levels in drinks vary, but two cups of instant coffee contain about 200mg of caffeine.

Will my weight affect my fertility?

Being either underweight or overweight can cause hormone imbalances. This can affect your fertility by making you less likely to ovulate (Anderson 2010, SIGN 2010). It can also increase the risk of complications in pregnancy (NICE 2010, NICE 2013, SIGN 2010).

If you can, try to achieve a healthy weight, with a body mass index (BMI) of between about 19 and 25, before you conceive. This will increase your chances of conception and of having a healthy pregnancy. You can calculate your body mass index (BMI) with our BMI calculator.

If you have irregular periods and your BMI is 30 or higher, try to bring it down. Losing between 10 per cent and 20 per cent of your body weight can help to regulate your menstrual cycle. This, in turn, will improve your chances of conceiving (NICE 2010).

It’s best not to crash diet, though, as this can deplete your body’s nutritional stores. Aim to lose between 0.5kg and 1kg (between 1lb and 2lb) a week, which is a safe rate of weight loss (NICE 2010).

For best results, stick to a healthy, balanced diet of low-fat and low-sugar foods, combined with an exercise programme (CKS 2017, NICE 2010).

If you’re underweight, try to put on a few pounds. Being underweight can affect ovulation. And when you do conceive, your risk of miscarriage increases if you’re underweight (Hahn et al 2014).

Just as it’s best not to crash diet if you’re overweight, it’s best not to gorge on sugary, fatty foods to put on weight fast. These types of foods won’t give you the important vitamins and minerals you need. You're more likely to just put on body fat with these 'empty calories'.

Instead, try to get your extra calories from healthy food choices. For example, porridge made with whole milk and sprinkled with raisins makes a healthy, high-energy breakfast. At lunchtime try a jacket potato with baked beans. Or for a high-energy snack that's also high in protein, tuck into a piece of wholemeal toast with peanut butter (NHS 2017d).

It's a good idea to speak to your GP if you are worried about your weight. She may offer you some tests to find out if you have an underlying condition such as an underactive thyroid, which can affect your fertility.

Should I start exercising more before I conceive?

Getting fit before you conceive lays the foundations for a healthy pregnancy. Building your stamina, strength and flexibility can help you to:

maintain an active lifestyle during pregnancy and enjoy those nine months (NICE 2010)

Being active and taking regular exercise that strengthens your back muscles may help to stave off lower back pain once you are pregnant (NHS 2017d).

If you can, build exercise into your everyday life (CKS 2017). Try walking or cycling to work instead of taking the bus, or using the stairs instead of the lift.

Running is another good way to get fit before pregnancy. If you’re not already a runner, you may like to start now. Running shouldn’t be started for the first time during pregnancy. Your body produces the hormone relaxin during pregnancy. This loosens your joints and makes you more prone to injury (Tommy's 2018).

Start slowly and don’t push yourself too hard. If you have a pre-pregnancy check-up at your local surgery, you could have a chat to your doctor or nurse about starting an exercise programme.

Is smoking, drinking and taking drugs harmful when you’re trying?

Yes. There are many good reasons to stop smoking, stop taking drugs and give up or cut down on alcohol. Making these changes to your lifestyle is good for your own health and, once you’ve conceived, for your baby’s health and development (CKS 2017).

Studies show that smoking cigarettes is likely to make it harder for you to conceive (NICE 2013). There hasn’t been as much research into vaping and e-cigarettes. While they’re likely to be safer for you than smoking, we can’t be sure about the effects of vaping and some experts believe they are harmful (Korte 2016, McNeill et al 2015). So to be on the safe side, it's best to quit smoking altogether.

Recreational drugs, such as marijuana and cocaine, can affect your ovulatory and tubal function. This can make it harder for you to conceive (NICE 2013). Even drugs that are available over the counter or by prescription can harm your fertility (NICE 2013). It is therefore important to discuss your medication with a doctor before you start trying for a baby.

Drinking alcohol in the early weeks of pregnancy can increase your risk of miscarriage and increase your baby’s risk of long-term health problems. For these reasons, experts recommend that you avoid alcohol entirely while trying to conceive as well as during your pregnancy (DH 2016). Heavy drinking can also affect your partner's sperm (NHS 2015).

What if my job could be harmful once I get pregnant?

Some jobs can be hazardous to you and your unborn baby. If you are exposed to chemicals or radiation often, you may need to consider making changes before you conceive. Likewise, if you fly a lot or stand all day, think about how you might cope if you became pregnant.

If possible, tell your employer that you’re planning a pregnancy and ask about ways to avoid or eliminate hazards in your workplace (CKS 2017). If you don’t want to let your employer know that you’re trying for a baby, the Health and Safety Executive has information about how to make your work environment safer.

NICE. 2010. Weight management before, during and after pregnancy. Last updated March 2017. National Institute for Health and Clinical Excellence. Public health guideline, 27. www.nice.org.uk [Accessed August 2018]

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Comments

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